FcgRIIIa 158 V/F polymorphism predicts rituximab-induced late onset neutropenia in newly-diagnosed CD20-positive B-cell lymphoma but is not correlated with long-term survival: A prospective study at a single institution with long-term follow-up

Hung-Chih Lai^a, Szu-Chin Li^a, Yi-Chun Chen^{b, c}, Chih-Chia Yu^a, Ching-Chih Lee^{c, d}, Hon-Yi Lin^{c, e}, Shih-Kai Hung^{c, e}, Yu-Chieh Su^{a, c}

^a Division of Hematology–Oncology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^b Division of Nephrology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^c School of Medicine, Tzu Chi University, Hualian, Taiwan
^d Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^e Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

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Abstract
Objective

Rituximab is a commonly used treatment for CD20-positive B-cell lymphoma. Late onset neutropenia (LON) has been identified as a complication associated with rituximab. FcgRIIIa 158 V/F polymorphism has been correlated with LON. We want to explore the relation between FcgRIIIa 158 V/F polymorphism and survival outcome.

Materials and Methods

We examined a cohort of patients with newly diagnosed CD20-positive B-cell lymphoma who were treated with rituximab-based therapy. We identified patients with LON and analyzed their characteristics and survival outcomes. Furthermore, we used a multiplex polymerase chain reaction to detect FcgRIIIa 158 V/F polymorphism and correlated this with LON. After a 10-year follow-up, we analyzed the survival outcomes between groups with different FcgRIIIa polymorphisms.

Results

Seventy-two consecutive patients with CD20-positive B-cell lymphoma patients were examined. Eleven (15.2%) of these patients developed LON. The V/V and V/F polymorphisms were significantly associated with the occurrence of LON (p = 0.031), yielding an odds ratio for the development of LON of 1.47 (95% confidence interval, 1.21–1.78). The log-rank test showed no overall survival difference both in the occurrence of LON and different polymorphisms.

Conclusion

The FcgRIIIa polymorphism was significantly associated with development of LON. Furthermore, neither FcgRIIIa polymorphism nor LON predicted a patient's survival outcome according to the results of a long-term follow-up study.

Keywords
Fcg receptor polymorphism; Late onset neutropenia; Lymphoma